How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $177.83 | Professional | None | $147.91 | $154.88 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $239.88 | Professional | None | $120.23 | $190.55 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $309.03 Typical High $575.44 | Facility | None | $234.42 | $309.03 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $446.68 | Professional | None | $173.78 | $229.09 | $446.68 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $416.87 | Professional | None | $141.25 | $213.80 | $416.87 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $389.05 | Professional | None | $162.18 | $208.93 | $389.05 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $29.51 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $109.65 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $21.88 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.79 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $109.65 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $102.33 | $109.65 | $125.89 |
Where New Hampshire sits
The same service costs 3.8 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Hampshire· 19th of 51
$200
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.